Nutrition is a vital part of being well, and an even more important part to getting well (or healing). It’s a critical part of prevention, yet if I surveyed physicians or lay people, and asked them “Does diet therapy work?” chance are at least 70 percent of them would say: “No”. (For one thing, they have no idea what diet therapy really is).
Why is that? My theory is that the delivery of medical nutrition therapy is either underutilized or delivered by the wrong individual. Registered dietitians-nutritionists (RDNs) are nutrition experts that are educated and trained to understand human physiology and how diet relates to it. RDNs also are trained to provide nutrition assessments, and behavior counseling to deliver current diet therapies for both wellness and disease.
Just as I would not propose to offer you physical therapy or take your blood pressure, I wouldn’t expect a nurse or physical therapist to be able to help you lower your blood lipids or counsel you about diet and diverticulitis. Nor would I expect them to know how to interpret your BMI (body mass index – which is still an appropriate tool to include in nutrition assessment). They don’t have the training in nutrition assessment, nor do their fields of expertise mandate that they keep abreast of the latest epidemiological studies on diet and disease, and the resulting protocols.
Perhaps this is why I chose to no longer work in the clinical setting, but instead in research and nutrition communications. It is extremely frustrating to see how underutilized RDNs are, both locally and all over the nation. I absolutely know that people with diabetes, heart disease (high blood pressure, congestive heart failure), pregnancy, anemia, gastrointestinal disorders (such as Celiac, Crohn’s disease or ulcerative colitis), or obesity, would have better clinical outcomes if every single one of them were referred to an RDN for a diet prescription and counseling. Sometimes it could even take just two simple 30 to 60 minute visits, and many insurance carriers now cover it. This should be routine care in my opinion, and there’s plenty of research that shows that diet therapy and lifestyle interventions, when delivered properly, work.
It is the in-person delivery of this diet therapy that leads to positive outcomes, not just knowing what the dietary guidelines may be.
- Most people with a psychiatric disorder require cognitive behavior therapy from trained therapists to direct and coach them, for best outcomes.
- Most people with joint pain or a limited/altered range of motion issue benefit from a physical therapist to act as both director and coach, to aid in healing, and possibly eliminate need for surgery or limit use of medications.
- Most people who would benefit from diet therapy need a registered dietitian to properly assess them, and direct and coach them. No other health professional has this unique skill set.
According to the Academy of Nutrition and Dietetics (the governing board for RDNs), Medical Nutrition Therapy (MNT) is:
“…an essential component of comprehensive health care. Individuals with a variety of conditions and illnesses can improve their health and quality of life by receiving medical nutrition therapy. During an MNT intervention, RDs counsel clients on behavioral and lifestyle changes required to impact long-term eating habits and health.”
Medical Nutrition Therapy is not just a “Go on a diet” or “Try following a low fat diet to lower your cholesterol” directive. It is a clearly coordinated process, provided by a Registered Dietitian-Nutritionist, which includes:
- Performing a comprehensive nutrition assessment to determine a nutrition diagnosis
- Planning and implementing a personalized nutrition intervention
- Monitoring and evaluating an individual’s progress over subsequent visits
So the next time your doctor wants to add another medication for blood pressure, cholesterol, or possibly a gastrointestinal problem – ask for a referral to a local registered dietitian. Actually applying appropriate medical nutrition therapy after a proper nutrition assessment, and just saying, “I tried a diet”, are two completely different things.
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